The Benefits of a Few Extra Zzzzz’s

Whether you nap at home or work, as little as 10-15 minutes can make a positive difference in how you feel and function.

“The most talked about benefits are improved mood and performance,” says William A. Anthony, PhD, author of The Art of Napping and The Art of Napping at Work. Naps, he says, also improve concentration, alertness, creativity, and reaction time.

There are long-term benefits, as well.

“[Naps] tend to reduce the chance of heart attacks, strokes, and certainly stress,” explains James B. Maas, PhD, a Cornell University sleep researcher and author of Power Sleep. He cites one study that showed a 30% lower incidence of cardiovascular disease in people who napped.

“Changes in metabolism and heart, pulse, and breathing rates are all the sorts of things that are modified and reduced in a period of quiescence,” says Dr. Maas.

Following Your Body’s Lead

How long is the ideal nap? Most experts say it is anywhere from 15-30 minutes.

“Long enough to reap the benefits and restore some of the sleep debt that we’re all carrying, but short enough so you don’t go into delta, or deep, sleep,” says Dr. Maas.

A full sleep cycle lasts about 90 minutes, says Pierce H. Howard, PhD, author of The Owner’s Manual for The Brain. Because nappers typically reach only the alpha state or light sleep stage, they tend to feel refreshed instead of sluggish when they wake.

“But if we get into deep sleep, or REM state, and then wake up before the cycle’s over, we feel like a truck hit us,” says Dr. Howard.

The Measure of a Nap

You are ready for a nap when you start feeling drowsy, and that commonly takes place eight hours after you get up in the morning or 12 hours after the midpoint of the previous night’s sleep. For the average person, that time occurs somewhere between 2:00 p.m. and 4:00 p.m. As a result, people become tired and less alert. Statistics also show that between 2:00 p.m. and 4:00 p.m. is the time when the most industrial, traffic, and domestic accidents occur.

Making Up for Lost Sleep

“We’ve cut down on our sleep by 20% over the last 100 years, and the human body can’t keep up with that type of change,” says Dr. Maas. “The best solution is good nocturnal sleep, but as a stop-gap measure, napping is a tremendous success.”

Poor health and eating habits, stress, exercise (or lack of it), lack of fresh air, and working under artificial lights can also induce the craving for a nap.

Napping and Sleep Disorders

If you are healthy and do not have a sleep disorder, you should be able to take a judiciously timed nap and sleep at night without any problems, says Dr. Anthony.

For people with sleep disorders, such as sleep apnea or narcolepsy, a nap may also prove beneficial.

“I recommend napping for patients with excessive daytime sleepiness caused by disorders,” says Karl Doghramji, MD, director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia. On the other hand, if a person cannot sleep at night from insomnia, a nap during the day might add to the problem. It all depends on the person.

Workplace Napping

Because many people are at work during the afternoon when the drowsy feeling sets in, they ignore the need for a nap. Instead, they go to the water cooler, drink caffeine, or stare at their computer screen and don’t do anything, says Dr. Anthony.

But it makes sense to take a quick nap at work for two reasons. During that period, workers are not highly productive and are more error prone. And if you work through that period, some negative aspect of fatigue can emerge later. For example, once you are home, you might fall asleep in front of the television, and studies show that evening naps may interfere with regular nighttime sleep.

Tips for Successful Napping

The experts offer the following tips for incorporating naps into your life:

• Give yourself permission to nap. Do not feel guilty.
• Remember all the performance, mood, and health benefits you gain by taking a nap.
• Avoid caffeine after your first morning cup of coffee.
• Surround yourself with items that make you comfortable, like a favorite pillow, blanket, soothing sounds, and a couch or chair.
• Use an alarm clock or timer, so that you will not slip into a deep sleep or worry about when you will wake up (which makes it hard to relax).
• Nap consistently at the same time every day, even if it is just a quick rest.

Be sure to check out iHerb’s selection of supplements that may help with sleep support! New to iHerb? Use Coupon Code WOW123 to get $5 off any first time order.

RESOURCES:

National Heart, Lung, and Blood Institute

National Sleep Foundation

CANADIAN RESOURCES:

Canadian Lung Association

Canadian Sleep Society

REFERENCES:

Anthony WA. The Art of Napping. Burdett, NY: Larson Publishing; 1997.

Anthony WA. The Art of Napping at Work: The No-Cost, Natural Way to Increase Productivity and Satisfaction. Burdett, NY: Larson Publishing; December 1999.

Howard PJ. The Owner’s Manual for the Brain: Everyday Applications from Mind-Brain Research. Austin, TX: Bard Press; 2000.

Maas JB. Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance. New York, NY: HarperCollins; 1999.

National Sleep Foundation website. Available at: http://www.sleepfoundation.org/.

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True or False? Never Wake a Sleepwalker

If you’ve ever woken up in the middle of the night to find someone sleepwalking around the house, you know that it’s an unnerving experience. But should you wake the person up? Some people argue that waking sleepwalkers will confuse and anger them, possibly endangering the person doing the waking. Others believe that sleepwalkers should be woken up because they may harm themselves if left alone.

Sleepwalking is called a disorder of arousal, and family history is usually what determines whether or not a person will be a sleepwalker. Common triggers, such as sedatives, medications, or fever, will often only affect those people who are predisposed to sleepwalking. About 18% of the population is prone to sleepwalking, and sleepwalking is common in children (especially those whose parents were sleepwalkers when they were young). Most children who start sleepwalking at an early age outgrow it by the time they reach adolescence. However, if children start sleepwalking after age 9 it is likely that they will continue into adulthood.

Evidence for the Health Claim

The idea that sleepwalkers should not be woken up is a widely held belief. Some people think waking the sleepwalker will increase his risk of a heart attack. However, most believe that the person doing the walking is at a greater risk for harm.

Research on similar forms of sleep pathology has found that some people do get aggressive when woken up from the non-REM (rapid eye movement) phase of the sleep cycle (which is when sleepwalking occurs). One study attributed 20 cases of murder and 30 criminal offenses to “sleep drunkenness,” a condition similar to sleepwalking. Other studies also caution against waking up sleepwalkers because of possible resistance and violence.

Evidence Against the Health Claim

The myth that a sleepwalker should be left alone stems from an ancient belief that the soul leaves the body during sleep, and if a sleepwalker is woken up they will be a body without a soul. Metaphysical reasoning aside, the presumption that sleepwalkers will exhibit wildly disturbed behavior when awakened is largely unfounded. Although some people may become aggressive, researchers have found that most of the time sleepwalkers are simply confused, disoriented, scared, or embarrassed. Waking a sleepwalker should be done as gently as possible to avoid such responses.

It is difficult to wake a person who is sleepwalking, and many sleep experts recommend gently guiding the person back to bed instead. Sleepwalkers most likely will not remember the incident in the morning. It is important to get the person to go back to sleep in his or her bed because sleepwalkers often engage in activities that should require full attention, and thus are dangerous to do while partially asleep. Such behaviors include leaving the bed and walking down stairs, eating, drinking, cooking, and even driving a car. Therefore, leading the sleepwalker back to bed, and waking him if necessary, is the safest option.

Conclusion

Although it is possible that waking a sleepwalker could be met with resistance or aggression, it is highly unlikely that the person doing the waking will be harmed. Instead, the sleepwalker could unknowingly jeopardize his own health if not deterred and helped back to bed. It is difficult and often unnecessary to wake a sleepwalker, but doing so may be the best option if the person refuses to return to bed with gentle guidance.

Click here to see iHerb’s selection of supplements that may help with sleep support! New to iHerb? Use Coupon Code WOW123 to get $5 off any first time order.

REFERENCES:

Bonkalo A. Impulsive acts and confusional states during incomplete arousal from sleep: criminological and forensic implications. Psychiatr Q . 1974;48:400-409.

Children and sleepwalking. Stanford University website. Available at: http://www.stanford.edu/~dement/slpwalking.html . Updated April 1998. Accessed November 10, 2008.

Mahowald MW. Your questions answered. Neurology Now . 2006;2:33.

O’Connor A. The claim: never wake a sleepwalker. The New York Times . September 13, 2005; F6.

Plazzi G, Vetrugno R, Provini F, et al. Sleepwalking and other ambulatory behaviours during sleep. Neurol Sci. 2005;26:193-198.

Sleepwalking in children. Funded Agency Channel website. Available at: https://fac.dhs.vic.gov.au/documents/october_05.pdf . Accessed August 1, 2006.

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Dealing with Insomnia

There are different types of insomnia, most of which cause people to lay in bed awake, frustrated that they are unable to fall asleep or stay asleep. As a result, they toss and turn, and irritability increases. Insomnia can take various forms, including early morning arousal (difficultly staying asleep), sleeping latency (difficulty falling asleep), fragmented sleep (waking up multiple times during the night), and sleeping very lightly and awakening feeling unrefreshed. Many people with insomnia want to avoid medication because they are concerned about potential addiction, or feeling “spacey” or drowsy throughout the day.

Finding the Causes of Insomnia

Sleep-wake cycles are dictated by internal circadian rhythms. These rhythms are strongly influenced by light entering through the eyes, which signals the brain to regulate production of certain hormones including one called melatonin. Circumstances that unnaturally diminish the entrance of light into the eyes can disrupt the natural circadian rhythm, the production of necessary hormones, and therefore, an individual’s proper sleep-wake cycle. Such circumstances include blindness and failing eyesight due to aging. Traveling to different time zones and jet lag, as well as working the night shift, disturb the natural circadian rhythm as well.

Insomnia can also be a sign of an underlying medical condition such as depression, an over-active thyroid, high blood pressure, heart disease, asthma, sleep apnea, restless leg syndrome, dementia, or pain disorders.

Several lifestyle factors can contribute to sleep disturbance. Keeping a sleep-wake diary is helpful in identifying and modifying these factors, which include:

• Use of stimulants, including caffeine, nicotine, and ingredients in common drugs such as cold and weight-loss medications. Some people have difficulty falling asleep, others awaken during the night.
• Use of alcohol. While it may help you fall asleep, alcohol consumption is likely to produce interrupted sleep and is not recommended as an insomnia treatment because of the possibility of addiction.
• Erratic work hours, such as rotating- or night-shifts
• Exercise (for example, exercising close to bedtime), or lack of regular exercise
• Eating habits (for example, eating too late at night)
• Stress
• Excessive time on the computer or watching TV

Treating Insomnia With Lifestyle Changes

The most effective and frequently used conventional treatments to establish a restful sleep pattern are behavioral, not medicinal. These include achieving proper “sleep hygiene,” as well as making other lifestyle alterations.

• Relaxation techniques—A multidisciplinary team, including medical doctors, specializing in sleep disturbances can train and guide people in such approaches as yoga, meditation, deep relaxation, biofeedback, hypnosis, massage, and/or guided imagery. Practicing one of these techniques within 30 minutes of bedtime is particularly helpful. Simple changes in bedtime routine may also be effective. These include taking a warm bath, listening to soothing music, and drinking warm milk.
• Acupuncture—Positive effects of the use of this ancient Chinese practice have been shown; however, more proof is needed before the World Health Organization will recommend acupuncture as an effective treatment for insomnia. But some reports do suggest a success rate for the treatment of insomnia as high as 90%. A typical protocol is to receive acupuncture treatments weekly until a normal sleep pattern is achieved, followed by maintenance sessions. However, a licensed and certified acupuncturist will determine the most appropriate treatment regimen for each individual.
• Exercise—Regular exercise is an excellent way to regulate circadian rhythms and the sleep-wake cycle. It is best performed some time prior to dinner, as exercising too close to bedtime can make it difficult to fall asleep.
• Light therapy—For night-shift workers suffering from insomnia, light therapy can be quite effective. This therapy involves using very bright lights in the work setting and then, when trying to sleep during the day, doing so in a very dark room while wearing sunglasses.
• Cognitive therapy—This behavioral method involves addressing misconceptions and unrealistic expectations about both insomnia and the nature of sleep. Some issues addressed during cognitive therapy include napping to compensate for poor sleep at night, anxiety about bedtime, fear of sleeplessness, beliefs about necessary hours of sleep, and attributing insomnia to age, ability to sleep, and/ or possible chemical imbalance. One study found that cognitive behavioral therapy decreased sleep latency by 54%, as compared to 16% with relaxation therapy and 12% with placebo treatment.

Treating Insomnia With Herbs and Supplements

While some cultures have a long history of using supplements and herbal remedies for the treatment of insomnia, such practices have only gained popularity over the last few decades in the United States and other Western nations. Over this relatively short time, though, certain substances, once popular, have already gone out of favor (for example, L-tryptophan is now off the US market due to instances of a rare muscle disorder) or have been somewhat disappointing in light of the initial attention they received (see melatonin below). Those that hold the most promise are:

Valerian Root

The most promising of the botanicals seems to be valerian root ( Valerian officianalis). Valerian root is classified as “generally recognized as safe” in the US for food use. Short term studies—lasting up to two weeks—suggest success in treating some types of insomnia, particularly those related to anxiety, nervousness, or stress, such as a fitful, restless sleep with frequent arousals. Some questions remain, though, including: Should valerian be taken indefinitely or only until the cycle of insomnia is broken? Is valerian safe to take for a long period of time?

Some people have had success with valerian for several types of insomnia. The dose recommended by Germany’s Commission E (a governing body that reviews the safety and efficacy of herbal supplements) is 2,000-3,000 millgrams (mg) of valerian root extract per day either in one dose or three divided doses. Studies have also found success with 400 mg a night. Some doctors recommend the latter, lower dose.

Lavender

Either sprayed as a mist or used in another form of aromatherapy, lavender aids in a more complete night’s sleep, particularly in the elderly. Lavender flower ( Lavandula augustifolia) is approved in Germany for oral use as a tea to help soothe the person with insomnia and improve sleep patterns.

Lemon Balm

Valerian is thought to be particularly successful when used in conjunction with lemon balm ( Melissa officianalis). Lemon balm is approved in both Germany and Great Britain to improve sleep disturbances. When used alone, it should be taken as a loose-leaf tea (1.5-4.5 grams per cup of hot water) or dried extract in a capsule (300-900 mg). When used in conjunction with valerian root, though, as little as 160-300 mg of lemon balm extract has been shown to enhance the effects of valerian.

Other Herbs

Other herbs approved in both Germany and Great Britain for mild to moderate sleep disturbances include:

• Passion flower ( Passiflora incarnata)—This is used particularly for restless sleep related to nervousness or anxiety. Recommended dose: two grams of the dried extract at bedtime in combination with lemon balm and valerian root
• Chamomile flower ( Matricaria recutita)—This is used for mild sleep disturbances. Recommended dose: three grams of the tea before going to sleep
• Hops ( Humulus lupulus)—This is used particularly for restless sleep related to nervousness and anxiety. Recommended dose: 300-500 mg of dried extract capsules or tea with valerian root
• Orange peel ( Citrus aurantium)—This is used for transient sleeplessness in both children and adults. Recommended dose: 2 grams of tea in boiled water

Treating Insomnia With Other Options

Prescription Sleep Medications

Long-term use of sleeping pills is not recommended, as addiction is likely, and more research needs to be done on safety and effectiveness. For temporary relief of insomnia, the following medications may be prescribed:

• * Short-acting sedative-hypnotics (non-benzodiazepines):  Zolpidem (Ambien), Zaleplon (Sonata) and  Eszopiclone (Lunesta)
• * Melatonin receptor agonists (used for sleep latency but not effective for fragmented sleep):  Ramelteon (Rozerem)
• * Benzodiazepines (tranquilizers):   Flurazepam (Dalman), Temazepam (Restoril) and Estazolam (ProSom)

The National Sleep Foundation recommends that people taking sleep medication begin with the lowest possible dose that is effective, use the drugs on a short-term basis, and take the drugs intermittently if they are using them on a long-term basis.

In certain situations, taking antidepressant medications like Trazodone or Remeron, which have sedating effects, may be very beneficial for patients with insomnia.

For more information on treating insomnia with medication, click here.

Finding a Nonpharmacologic Insomnia Treatment

Melatonin

This neurotransmitter is secreted by the pineal gland and it regulates the sleep cycle. Melatonin is secreted at night, and the secretion is suppressed by bright light during the day. When melatonin secretion is not synchronized with the light-dark cycle, sleep disturbances occur. Frequently touted as a valuable supplement for insomnia, melatonin has shown only mixed results.

Melatonin has been valuable for some people who do not fall asleep easily, as well as for temporary sleep disturbances from a change in schedule (daytime work to nighttime) or sudden disruption of the circadian rhythm as with jet lag. Melatonin may also be helpful for people on a certain class of medications called beta-blockers, used for high blood pressure and heart disease. This supplement is not effective in the elderly, but does work for people with schizophrenia who frequently suffer from insomnia.

The effects of melatonin are very individual. Speak with your doctor if you would like to try it, particularly because there are certain circumstances in which it should not be used until more information is available: pregnancy, breast-feeding, autoimmune disorders, leukemia, and lymphoma.

The dose of melatonin recommended for insomnia is 1-3 mg per day. However, as little as 0.3 mg per day has induced improvement in sleep in some people. Side effects from melatonin are generally not seen if less than 1 mg/day is taken, while more than 5 mg/day can exacerbate sleep disturbances.

Given the information available regarding melatonin, some doctors recommend taking it before going on a trip that involves a change in time zone. In this case, start 2-3 days before leaving and take for 2-3 days after arriving at the new destination.

Vitamin B12

Like melatonin, vitamin B12 is useful for some people and not for others. It is thought to help reestablish a disrupted circadian rhythm and normalize levels of stress hormones. Therefore, it may be helpful for stress- or anxiety-related insomnia as well as short, situational insomnia from jet lag or a recent change from day to night work.

Magnesium

Some studies suggest that magnesium may be useful for insomnia related to restless leg syndrome and for reduction of the amount of anesthetic needed in the case of surgery. How these two facts translate into induction of sleep with other types of insomnia, though, is unclear.

Identifying Herbs That Induce Insomnia

In addition to caffeine, excessive alcohol, and particular medications, certain herbs sold over the counter can induce wakefulness. These include ginseng, ephedra, yohimbe, and cola nut. The hormonal supplement DHEA may also contribute to insomnia.

Putting Insomnia to Rest

Insomnia is a common problem that results not only in personal frustration and discomfort, but also is associated with decreased work performance, lost productivity, accidents, and hospitalization. Treatment for insomnia must be specific to the individual to achieve optimal results. Prescription medications (“sleeping pills”) may be used to achieve short-term results. However, nonprescription treatments are commonly recommended and inexpensive, and also are effective. Talk with your doctor about several strategies that may be combined to help you find relief from problems with sleeping, and to assist you in getting a restful, complete night’s sleep.

Click here to see iHerb’s selection of supplements that may help with sleep support! New to iHerb? Use Coupon Code WOW123 to get $5 off any first time order.

RESOURCES:

National Heart Lung and Blood Institute

National Sleep Center

CANADIAN RESOURCES:

Better Sleep Council Canada

Canadian Sleep Society

REFERENCES:

Bain KT. Management of chronic insomnia in elderly persons. Am J Geriatr Pharmacother . 2006;4(2):168-92. Review.

Becker PM. Pharmacologic and nonpharmacologic treatments of insomnia. Neurol Clin . 2005;23(4):1149-63. Review.

Mayers AG, Baldwin DS. Antidepressants and their effect on sleep. Hum Psychopharmacol . 2005;20(8):533-59. Review.

Ringdahl EN, Pereira SL, Delzell JE Jr. Treatment of primary insomnia. J Am Board Fam Pract . 2004;17:212-219.

World Health Organization. Diseases and disorders that can be treated with acupuncture. Traditional Chinese Medicine and Acupuncture Health Information Organization website.  Accessed August 20, 2007.

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Are You Getting Enough Sleep?

The Function of Sleep

Why is sleep so critical to our well-being? If resting in bed were all it took to recharge body and mind for the coming day, insomniacs could take in their favorite late night television and start the next day fresh. But surprisingly, it’s not how much sleep you get that’s important—it’s the level of sleep you achieve that truly restores you, body and mind.

Sleep can be divided into two crucial phases:

• Non-rapid eye movement (NREM) sleep takes up 80% of the average dreamer’s night. The earliest phase of NREM sleep begins with general relaxation of muscles. This relaxed state eventually culminates in the deepest sleep level when it appears that protein synthesis, growth hormones, immune function, and the mind are given a boost. Delta waves—the slowest and largest waves—signal the onset of this most rejuvenating sleep level, which constitutes 50% of an adult’s sleep time.
• Rapid eye movement (REM) sleep takes up about 20% of an average sleeper’s night. Dreams that occur during REM sleep might provide, in a sense, a sorting through of free-floating information. Prolonged REM deprivation has been linked to excessively anxious or emotional behavior that dissipates once more regular sleeping habits are achieved. REM sleep is thought to be the most important period for mental revitalization.

Risky Consequences From Sleeplessness

In addition to productivity and safety consequences, research shows that people who are chronically sleep deprived may also be more likely to suffer from:

• Depression
• Cardiovascular disease (eg, coronary heart disease, stroke, heart attack, hypertension)
• Decreased enjoyment in life
• Poor work performance, leading to increased absenteeism and decreased number of promotions

Who Is Most Affected?

Late shift workers. Not only do Americans give up a good night’s rest in an attempt to keep up with the hectic pace of the electronic age, many, including late shift healthcare, military and public safety workers, nuclear power plant operators, medical residents, and long-haul truck drivers, are building daily schedules against the body’s natural circadian rhythm. That rhythm dictates that the longest period of sleepiness occurs during the hours of 1 a.m.–6 a.m. Thus, people who work the late shift lose out on the time that the body is programmed for the deepest and most beneficial sleep.

Older adults. The elderly, too, cope with a special set of difficulties that keeps them from getting the sleep they need. Aging brings on a host of health-related problems that interrupt sleep, such as pain from arthritis, medications with side effects that disturb rest, or depression brought on by the discomforts of the aging process. More than any other population, the elderly rely on medications that keep them up at night. Moreover, a more sedentary lifestyle doesn’t allow for the expenditure of energy that results in restful sleep. Last, a slowing of what is known as delta wave activity in the brain doesn’t allow for the same degree of deep sleep per night as enjoyed in youth.

But none of this means that the elderly don’t need as much rest as everyone else. The combination of conditions that change the sleep habits of the elderly only indicates that they need to alter their sleep habits so that they get enough shut-eye.

Tips for Better Sleep

In general, people are so used to going without enough sleep that they don’t recognize that their sleeping habits make sound slumber unlikely. Following these simple tips will help you settle down for a good night’s rest. Do the following to improve the quality of your sleep as well as to get more restful sleep:

• Avoid caffeine, nicotine, alcohol, and exercise at least four hours before bedtime. Caffeine and nicotine are stimulants, and alcohol, though a depressant that makes falling asleep easier initially, interferes with deep sleep later on during the night. Exercise also acts as a stimulant, but a workout earlier in the day can improve nighttime rest.
• Leave worrying outside the bed. If you stay awake worrying about things you have to tackle the next day, write out a list of “to-dos” to take the pressure off. Then put the list aside to deal with the next day.
• Keep other activities out of the bedroom. Don’t confuse your bedroom with your family room. Keep your television viewing and internet surfing out of your sleeping quarters. You need to associate your bedroom with sleep and not activities that will keep your mind engaged.
• Don’t try to “force” yourself to sleep. You’ll just lie awake staring at the clock. After 20 minutes of wakefulness, go to another room to read or perform some other quiet activity. Return to your bedroom only when you’ve become tired enough to sleep.
• Temperature counts. Keep your bedroom set up for a restful night’s sleep with a comfortable mattress and proper temperature setting. A too-hot or too-cold room can keep you awake.
• Reduce noise levels. Apartment-dwellers with noisy neighbors or those on heavily trafficked streets can block out noise with a fan or sound-simulating machine that mimic nature sounds (such as the ocean or rain).
• Avoid stimulation before sleeping. Try not to engage in anything that will give you a second wind just before bed, such as viewing an action-packed movie or sitting in a brightly lit room. Instead, try listening to soothing music or reading.
• Slow down. Don’t hurriedly get ready for bed at the last minute. Brush your teeth and wash yourself a while in advance. Try to stick with an early-to-bed, early-to-rise pattern. That way, you won’t go to bed too late during the work week and need an alarm clock each morning to wake you out of a sound sleep.

If you’re troubled with chronic difficulties falling asleep—or staying asleep—see a doctor. You may discover, for example, that what seems like simple snoring is actually sleep apnea. Other sleep disorders, such as restless legs syndrome (unpleasant sensations in the legs combined with irresistible urge to move) and narcolepsy (sudden and involuntary episodes of sleepiness) should also be discussed with your physician. Along with treating specific disorders, physicians can prescribe general sleep aids.

Click here to see iHerb’s selection of supplements that may help with sleep support! New to iHerb? Use Coupon Code WOW123 to get $5 off any first time order.

RESOURCES:

American Academy of Sleep Medicine

National Center on Sleep Disorders Research

NIH National Heart, Lung, and Blood Institute

National Sleep Foundation

CANADIAN RESOURCES:

Better Sleep Council Canada

Canadian Sleep Society

REFERENCES:

Drugs and insomnia. NIH Consensus Development Conference. Consensus development conference summary. Vol 4, No 10, National Institutes of Health, Bethesda, MD, 1984:1.

Sateia, MJ, Nowell, PD. Insomnia. Lancet. 2004; 364:1959.

Silber, MH. Clinical practice. Chronic insomnia. N Engl J Med. 2005; 353:803.

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